Velarion Records

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Skilled nursing facility · CMS certification number 125062

HALE KUPUNA HERITAGE HOME, LLC

KOLOA, Hawaii · Medicare and Medicaid

Certified beds, as filed in Care Compare: 84

Finances, as filed

From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.

Cost report for 1 January 2024 to 31 December 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 29 August 2025.

Revenue and expenses, fiscal year 2024
FigureAs filedWhere it comes from
Total patient revenue$9,869,766CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$1,481,580CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$8,388,186CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$8,074,594CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$313,592CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$577CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$314,169CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $314,169 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2024
FigureAs filedWhere it comes from
Total facility beds, all components84CMS-2540-10 worksheet S300001 line 800 column 100
Bed days available, all components30,744CMS-2540-10 worksheet S300001 line 800 column 200
Medicare (Title XVIII) patient days305CMS-2540-10 worksheet S300001 line 800 column 400
Medicaid (Title XIX) patient days14,914CMS-2540-10 worksheet S300001 line 800 column 500
Other-payer patient days1,922CMS-2540-10 worksheet S300001 line 800 column 600
Total patient days, all components17,141CMS-2540-10 worksheet S300001 line 800 column 700
Medicare discharges5CMS-2540-10 worksheet S300001 line 800 column 900
Medicaid discharges8CMS-2540-10 worksheet S300001 line 800 column 1000
Other-payer discharges15CMS-2540-10 worksheet S300001 line 800 column 1100
Total discharges, all components28CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days61CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days1,864.25CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days612.18CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1436534, read from the public cost report file SNF10FY2024.zip.

Fiscal year 2023, ended 31 December 2023

Cost report for 1 January 2023 to 31 December 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 23 August 2024.

Revenue and expenses, fiscal year 2023
FigureAs filedWhere it comes from
Total patient revenue$8,284,438CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$1,315,345CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$6,969,093CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$7,258,778CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$289,685CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$395,946CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$106,261CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $106,261 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2023
FigureAs filedWhere it comes from
Total facility beds, all components84CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components16,680CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components65CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days30.63CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days1,680.75CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days256.62CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1392975, read from the public cost report file SNF10FY2023.zip.

Fiscal year 2022, ended 31 December 2022

Cost report for 1 January 2022 to 31 December 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 29 August 2023.

Revenue and expenses, fiscal year 2022
FigureAs filedWhere it comes from
Total patient revenue$8,280,908CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$420,049CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$7,860,859CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$7,473,539CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$387,320CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$375,990CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$763,310CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $763,310 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2022
FigureAs filedWhere it comes from
Total facility beds, all components84CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components17,095CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components37CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days23.92CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days1,339.7CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days462.03CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1363395, read from the public cost report file SNF10FY2022.zip.

Fiscal year 2021, ended 31 December 2021

Cost report for 1 January 2021 to 31 December 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 20 September 2022.

Revenue and expenses, fiscal year 2021
FigureAs filedWhere it comes from
Total patient revenue$10,234,743CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$2,273,863CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$7,960,880CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$8,600,486CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$639,606CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$945,676CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$306,070CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $306,070 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2021
FigureAs filedWhere it comes from
Total facility beds, all components84CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components20,174CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components61CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days31.19CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days1,221.33CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days330.72CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1332963, read from the public cost report file SNF10FY2021.zip.

Fiscal year 2020, ended 31 December 2020

Cost report for 1 January 2020 to 31 December 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 17 November 2021.

Revenue and expenses, fiscal year 2020
FigureAs filedWhere it comes from
Total patient revenue$10,925,093CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$2,661,684CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$8,263,409CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$8,882,274CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$618,865CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$1,030,849CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$411,984CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $411,984 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2020
FigureAs filedWhere it comes from
Total facility beds, all components84CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components22,356CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components55CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days50.08CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days995.39CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days406.47CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1304715, read from the public cost report file SNF10FY2020.zip.

Fiscal year 2019, ended 31 December 2019

Cost report for 1 January 2019 to 31 December 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 28 October 2020.

Revenue and expenses, fiscal year 2019
FigureAs filedWhere it comes from
Total patient revenue$11,804,013CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$3,188,396CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$8,615,617CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$8,136,138CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$479,479CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$432,562CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$912,041CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $912,041 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2019
FigureAs filedWhere it comes from
Total facility beds, all components84CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components24,240CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components69CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days29CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days1,280.13CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days351.3CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1272528, read from the public cost report file SNF10FY2019.zip.

Fiscal year 2018, ended 31 December 2018

Cost report for 1 January 2018 to 31 December 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 30 July 2019.

Revenue and expenses, fiscal year 2018
FigureAs filedWhere it comes from
Total patient revenue$12,161,946CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$3,550,941CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$8,611,005CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$7,508,559CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$1,102,446CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$388,295CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$1,490,741CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $1,490,741 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2018
FigureAs filedWhere it comes from
Total facility beds, all components84CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components24,966CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components76CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days27.5CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days1,156.5CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days328.5CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1238769, read from the public cost report file SNF10FY2018.zip.

Fiscal year 2017, ended 31 December 2017

Cost report for 1 January 2017 to 31 December 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 21 August 2018.

Revenue and expenses, fiscal year 2017
FigureAs filedWhere it comes from
Total patient revenue$12,236,954CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$3,428,944CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$8,808,010CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$7,904,582CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$903,428CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$465,020CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$1,368,448CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $1,368,448 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2017
FigureAs filedWhere it comes from
Total facility beds, all components84CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components25,808CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components51CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days43.44CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days1,134.05CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days506.04CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1209373, read from the public cost report file SNF10FY2017.zip.

Fiscal year 2016, ended 31 December 2016

Cost report for 1 January 2016 to 31 December 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 11 August 2017.

Revenue and expenses, fiscal year 2016
FigureAs filedWhere it comes from
Total patient revenue$12,084,084CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$3,628,795CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$8,455,289CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$8,142,889CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$312,400CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$727,018CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$1,039,418CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $1,039,418 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2016
FigureAs filedWhere it comes from
Total facility beds, all components84CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components25,025CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components56CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days63.43CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days1,078.84CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days446.88CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1172920, read from the public cost report file SNF10FY2016.zip.

Fiscal year 2015, ended 31 December 2015

Cost report for 1 January 2015 to 31 December 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 23 August 2016.

Revenue and expenses, fiscal year 2015
FigureAs filedWhere it comes from
Total patient revenue$11,913,505CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$4,005,934CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$7,907,571CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$8,002,625CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$95,054CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$689,379CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$594,325CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $594,325 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2015
FigureAs filedWhere it comes from
Total facility beds, all components84CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components25,321CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components85CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days79.36CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days558.41CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days297.89CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1142302, read from the public cost report file SNF10FY2015.zip.

Fiscal year 2014, ended 31 December 2014

Cost report for 1 January 2014 to 31 December 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 17 September 2015.

Revenue and expenses, fiscal year 2014
FigureAs filedWhere it comes from
Total patient revenue$11,220,646CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$2,953,898CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$8,266,748CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$8,220,358CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$46,390CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$758,171CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$804,561CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $804,561 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2014
FigureAs filedWhere it comes from
Total facility beds, all components84CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components27,538CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components50CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days59.25CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days1,134.95CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days550.76CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1109794, read from the public cost report file SNF10FY2014.zip.

Fiscal year 2013, ended 31 December 2013

Cost report for 1 January 2013 to 31 December 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 9 September 2014.

Revenue and expenses, fiscal year 2013
FigureAs filedWhere it comes from
Total patient revenue$7,684,245CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts−$72,357CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$7,756,602CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$7,369,420CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$387,182CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$785,355CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$1,172,537CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $1,172,537 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2013
FigureAs filedWhere it comes from
Total facility beds, all components84CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components27,466CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components108CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days66CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days390.31CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days254.31CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1077654, read from the public cost report file SNF10FY2013.zip.

Fiscal year 2012, ended 31 December 2012

Cost report for 1 January 2012 to 31 December 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 28 June 2013.

Revenue and expenses, fiscal year 2012
FigureAs filedWhere it comes from
Total patient revenue$7,016,245CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts−$73,827CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$7,090,072CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$7,116,614CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$26,542CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$792,620CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$766,078CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $766,078 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2012
FigureAs filedWhere it comes from
Total facility beds, all components84CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components28,362CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components80CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days20CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days456.23CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days354.53CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1040553, read from the public cost report file SNF10FY2012.zip.

Fiscal year 2011, ended 31 December 2011

Cost report for 7 June 2011 to 31 December 2011 — a reporting period of 207 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 14 September 2012.

None of these figures is carried on this report.

CMS report record 1004257, read from the public cost report file SNF10FY2011.zip.

Nurse staffing

Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.

The staffing record →

Ownership, as filed with CMS

Care Compare

As filed in the CMS file dated 1 August 2026 (Care Compare ownership).

Owner or managerRoleTypeOwnership percentageAssociation
HATA, RANDALLADP OF THE SNFIndividualNOT APPLICABLEsince 11/12/2009
KISHABA, RICHARDADP OF THE SNFIndividualNOT APPLICABLEsince 11/12/2009
KOP, ARNOLDADP OF THE SNFIndividualNOT APPLICABLEsince 01/01/2025
LO, WESLEYADP OF THE SNFIndividualNOT APPLICABLEsince 01/01/2020
LORE, ANDREWADP OF THE SNFIndividualNOT APPLICABLEsince 02/01/2022
MCCLENNON, PAMELAADP OF THE SNFIndividualNOT APPLICABLEsince 04/01/2025
MORIKUNI, SUANNEADP OF THE SNFIndividualNOT APPLICABLEsince 01/01/2015
OHANA PACIFIC MANAGEMENT COMPANY INCADP OF THE SNFOrganizationNOT APPLICABLEsince 12/16/2025
SMITH, JOELADP OF THE SNFIndividualNOT APPLICABLEsince 12/01/2025
UKAUKA, LEAADP OF THE SNFIndividualNOT APPLICABLEsince 08/18/2021
UKAUKAU, BLOSSOMADP OF THE SNFIndividualNOT APPLICABLEsince 08/18/2021
MORIKUNI, SUANNECORPORATE OFFICERIndividualNOT APPLICABLEsince 01/01/2015
KISHABA, SANDRAINDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNFIndividualNOT APPLICABLEsince 12/01/2025
HATA, RANDALLOPERATIONAL/MANAGERIAL CONTROLIndividualNOT APPLICABLEsince 11/12/2009
KISHABA, RICHARDOPERATIONAL/MANAGERIAL CONTROLIndividualNOT APPLICABLEsince 11/12/2009
KOP, ARNOLDOPERATIONAL/MANAGERIAL CONTROLIndividualNOT APPLICABLEsince 01/01/2025
LO, WESLEYOPERATIONAL/MANAGERIAL CONTROLIndividualNOT APPLICABLEsince 01/01/2020
LORE, ANDREWOPERATIONAL/MANAGERIAL CONTROLIndividualNOT APPLICABLEsince 02/01/2022
MCCLENNON, PAMELAOPERATIONAL/MANAGERIAL CONTROLIndividualNOT APPLICABLEsince 04/01/2025
MORIKUNI, SUANNEOPERATIONAL/MANAGERIAL CONTROLIndividualNOT APPLICABLEsince 01/01/2015
OHANA PACIFIC MANAGEMENT COMPANY INCOPERATIONAL/MANAGERIAL CONTROLOrganizationNOT APPLICABLEsince 11/12/2009
SMITH, JOELOPERATIONAL/MANAGERIAL CONTROLIndividualNOT APPLICABLEsince 12/01/2025

Medicare enrollment

As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of HALE KUPUNA HERITAGE HOME, LLC (enrollment ID O20110323000349).

OwnerIndividual or organizationRoleOwnership percentageAssociation dateDescribed in the filing as
OHANA PACIFIC MANAGEMENT COMPANY INCOrganization5% OR GREATER DIRECT OWNERSHIP INTEREST10011/12/2009
Private equity company: No
Real estate investment trust: No
Holding company: Yes
RICHARD S KISHABAIndividual5% OR GREATER INDIRECT OWNERSHIP INTEREST1011/12/2009
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
RICHARD S. KISHABA 2010 DYNASTY TRUSTOrganization5% OR GREATER INDIRECT OWNERSHIP INTEREST907/30/2010
Private equity company: No
Real estate investment trust: No
Holding company: No
ANDREW LOREIndividualADP OF THE SNFCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.2/1/2022
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
ARNOLD WH KOPIndividualADP OF THE SNFCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.1/1/2025
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
BLOSSOM LUANA UKAUKAUIndividualADP OF THE SNFCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.8/18/2021
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
JOEL GREGORY SMITHIndividualADP OF THE SNFCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.12/1/2025
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
LEA UKAUKAIndividualADP OF THE SNFCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.8/18/2021
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
OHANA PACIFIC MANAGEMENT COMPANY INCOrganizationADP OF THE SNFCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.12/16/2025
Private equity company: No
Real estate investment trust: No
Holding company: Yes
PAMELA MCCLENNONIndividualADP OF THE SNFCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.4/1/2025
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
RANDALL I HATAIndividualADP OF THE SNFCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.11/12/2009
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
RICHARD S KISHABAIndividualADP OF THE SNFCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.11/12/2009
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
SUANNE MORIKUNIIndividualADP OF THE SNFCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.1/1/2015
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
WESLEY LOIndividualADP OF THE SNFCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.1/1/2020
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
SUANNE MORIKUNIIndividualCORPORATE OFFICER01/1/2015
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
ANDREW LOREIndividualOPERATIONAL/MANAGERIAL CONTROLCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.2/1/2022
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
ARNOLD WH KOPIndividualOPERATIONAL/MANAGERIAL CONTROLCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.1/1/2025
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
JOEL GREGORY SMITHIndividualOPERATIONAL/MANAGERIAL CONTROLCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.12/1/2025
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
OHANA PACIFIC MANAGEMENT COMPANY INCOrganizationOPERATIONAL/MANAGERIAL CONTROLCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.11/12/2009
Private equity company: No
Real estate investment trust: No
Holding company: Yes
PAMELA MCCLENNONIndividualOPERATIONAL/MANAGERIAL CONTROLCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.4/1/2025
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
RANDALL I HATAIndividualOPERATIONAL/MANAGERIAL CONTROLCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.11/12/2009
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
RICHARD S KISHABAIndividualOPERATIONAL/MANAGERIAL CONTROLCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.11/12/2009
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
SUANNE MORIKUNIIndividualOPERATIONAL/MANAGERIAL CONTROLCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.1/1/2015
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
WESLEY LOIndividualOPERATIONAL/MANAGERIAL CONTROLCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.1/1/2020
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.

Changes in ownership

Recent changes on this record

Inspections

Inspection cycleHealth inspectionFire safety inspectionHealth deficienciesFire safety deficiencies
112 March 202612 March 202684
26 September 20246 September 202471
322 September 202322 September 2023100

From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.

Deficiencies cited

25 deficiencies on file, newest inspection first
Inspection dateInspection typeTagCategoryWhat was citedScope and severityComplaintCorrectedCorrection date
12 March 2026HealthF 0565Resident Rights DeficienciesHonor the resident's right to organize and participate in resident/family groups in the facility.ENoDeficient, Provider has date of correction26 April 2026
12 March 2026HealthF 0628Resident Rights DeficienciesProvide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.DNoDeficient, Provider has date of correction26 April 2026
12 March 2026HealthF 0656Resident Assessment and Care Planning DeficienciesDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.DYesDeficient, Provider has date of correction26 April 2026
12 March 2026HealthF 0689Quality of Life and Care DeficienciesEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.GYesDeficient, Provider has date of correction26 April 2026
12 March 2026HealthF 0725Nursing and Physician Services DeficienciesProvide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.ENoDeficient, Provider has date of correction26 April 2026
12 March 2026HealthF 0804Nutrition and Dietary DeficienciesEnsure food and drink is palatable, attractive, and at a safe and appetizing temperature.ENoDeficient, Provider has date of correction26 April 2026
12 March 2026HealthF 0812Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.ENoDeficient, Provider has date of correction26 April 2026
12 March 2026HealthF 0880Infection Control DeficienciesProvide and implement an infection prevention and control program.ENoDeficient, Provider has date of correction26 April 2026
6 September 2024HealthF 0552Resident Rights DeficienciesEnsure that residents are fully informed and understand their health status, care and treatments.DNoDeficient, Provider has date of correction21 October 2024
6 September 2024HealthF 0600Freedom from Abuse, Neglect, and Exploitation DeficienciesProtect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.DYesPast Non-Compliance17 July 2024
6 September 2024HealthF 0609Freedom from Abuse, Neglect, and Exploitation DeficienciesTimely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.DNoDeficient, Provider has date of correction21 October 2024
6 September 2024HealthF 0610Freedom from Abuse, Neglect, and Exploitation DeficienciesRespond appropriately to all alleged violations.DNoDeficient, Provider has date of correction21 October 2024
6 September 2024HealthF 0625Resident Rights DeficienciesNotify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.DNoDeficient, Provider has date of correction21 October 2024
6 September 2024HealthF 0812Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.FNoDeficient, Provider has date of correction21 October 2024
6 September 2024HealthF 0880Infection Control DeficienciesProvide and implement an infection prevention and control program.FNoDeficient, Provider has date of correction21 October 2024
22 September 2023HealthF 0676Quality of Life and Care DeficienciesEnsure residents do not lose the ability to perform activities of daily living unless there is a medical reason.DNoDeficient, Provider has date of correction1 November 2023
22 September 2023HealthF 0684Quality of Life and Care DeficienciesProvide appropriate treatment and care according to orders, resident’s preferences and goals.DNoDeficient, Provider has date of correction1 November 2023
22 September 2023HealthF 0689Quality of Life and Care DeficienciesEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.DNoDeficient, Provider has date of correction1 November 2023
22 September 2023HealthF 0725Nursing and Physician Services DeficienciesProvide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.ENoDeficient, Provider has date of correction1 November 2023
22 September 2023HealthF 0758Pharmacy Service DeficienciesImplement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.DNoDeficient, Provider has date of correction1 November 2023
22 September 2023HealthF 0812Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.DNoDeficient, Provider has date of correction1 November 2023
22 September 2023HealthF 0867Administration DeficienciesSet up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.FNoDeficient, Provider has date of correction1 November 2023
22 September 2023HealthF 0880Infection Control DeficienciesProvide and implement an infection prevention and control program.DNoDeficient, Provider has date of correction1 November 2023
22 September 2023HealthF 0919Environmental DeficienciesMake sure that a working call system is available in each resident's bathroom and bathing area.DNoDeficient, Provider has date of correction1 November 2023
22 September 2023HealthF 0925Environmental DeficienciesMake sure there is a pest control program to prevent/deal with mice, insects, or other pests.DNoDeficient, Provider has date of correction1 November 2023

From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.

Penalties

Penalty dateTypeFine amountPayment denial beganPayment denial, daysFine ID
12 March 2026Fine$10,628138969

From the Care Compare penalties file NH_Penalties_Aug2026.csv, processed on 1 August 2026.

Care Compare provider information

FieldAs filed
Provider TypeMedicare and Medicaid
Ownership TypeFor profit - Limited Liability company
Legal Business NameHALE KUPUNA HERITAGE HOME, LLC
Date First Approved to Provide Medicare and Medicaid Services2011-06-07
Provider Resides in HospitalN
Continuing Care Retirement CommunityN
UrbanN
County/ParishKauai
Telephone Number8087427591
Chain NameOHANA PACIFIC MANAGEMENT CO.
Chain ID382
Provider Changed Ownership in Last 12 MonthsN
With a Resident and Family CouncilBoth
Automatic Sprinkler Systems in All Required AreasYes
Number of Certified Beds84
Average Number of Residents per Day45.3
Overall Rating4
Health Inspection Rating3
QM Rating3
Long-Stay QM Rating3
Processing Date2026-08-01

From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.

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On 1 July 2026: LEA UKAUKA no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. That is one line of the alert.

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The citable document for HALE KUPUNA HERITAGE HOME, LLC

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